Gut Cryptopatches Direct Evidence of Extrathymic Anatomical Sites for Intestinal T Lymphopoiesis

AbstractAthymic cytokine receptor γ chain mutant mice that lack the thymus, Peyer's patches, cryptopatches (CP), and intestinal T cells were reconstituted with wild-type bone marrow cells. Bone marrow–derived TCR− intraepithelial lymphocytes (IEL) first appeared within villous epithelia of small intestine overlying the regenerated CP, and these TCR− IEL subsequently emerged throughout the epithelia. Thereafter, TCR+ IEL increased to a comparable number to that in athymic mice and consisted of TCRγδ and TCRαβ IEL. In gut-associated lymphoid tissues of wild-type mice, only CP harbored a large population of c-kithighIL-7R+CD44+Thy-1+/−CD4+/−CD25low/−αEβ7−Lin− (Lin, lineage markers) lymphocytes that included cells expressing germline but not rearranged TCRγ and TCRβ gene transcripts. These findings provide direct evidence that gut CP develop progenitor T cells for extrathymic IEL descendants

Oxidative stress and temporomandibular joint disorders

Etiology of temporomandibular joint disorders (TMD) was estimated as excessive mechanical stresses inflicted on the temporomandibular joint (TMJ). The stresses including bruxism, clenching and oral parafunctional habits in daily life cause irreversible damage in the joint tissue. As the stress loading to the TMJ, it has been shown that increase of generation of free radicals, biosyntheses of arachidonic acid catabolite, release of neuropeptide and cytokines, and activation of matrix degrading enzymes from various TMJ tissues were observed. Few studies of reactive oxygen species (ROS) in TMD were reported. The authors postulate mechanisms that provably involved in the production of ROS in the TMJ and the subsequent induction of molecular events that may amplify damage to the joint tissues

Investigation of actual use of the new classification for temporomandibular disorders 2013 using a self-administered questionnaire

日本顎関節学会は，2013年に顎関節症の病態分類をDiagnostic Criteria for Temporomandibular Disorders（DC/TMD）に則して改訂した。改訂後約3年が経過したところで，全国の153の研修施設に対して本病態分類の導入状況と施行に関する調査を行った。調査内容は顎関節症の病態分類（2013年）の導入状況，診断方法，重複診断の採用，重複診断の際の治療優先度，臨床統計実施の有無，顎関節症の病態分類（2013年）の有用性，学生および研修医教育への有用性の8項目である。その結果，87％の施設で本病態分類を使用していた。診断方法は73％の施設で本病態分類を，DC/TMDに準拠している施設は13％であった。88％の施設で重複診断が採用され，その際の治療優先度は関節痛や筋肉痛に優先度をおいている施設が多かった。顎関節症の病態分類（2013年）に関して23％の施設が診断に「とても有用」，67％が「やや有用」と回答した。また，76％の施設で学生および研修医の教育に利用しているとの回答を得た。以上の結果から，顎関節症の病態分類（2013年）と重複診断は，その有用性から広く普及しつつあるが，今後治療優先度の指針の提示，画像診断などを盛り込んだ日本版DC/TMDの作成などが課題だと考える。In 2013, the Japanese Society for the Temporomandibular Joint announced a new classification of temporomandibular disorders (2013) based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Three years later, we investigated how the classification was viewed by 153 chief medical instructors at Japanese training institutions involved in TMD treatments. We explored the usage situation, methods employed, diagnostic overlaps, treatment priorities, availability of clinical statistics, utility of the new classification, and education of students and residents. We found that 87% of facilities used the new classification. In terms of diagnosis, the new classification was used by 73% of facilities, while 13% used the original DC/TMD. Multiple diagnoses were made in 88% of facilities, many of which prioritized treatment of arthralgia and myalgia. Overall, 23% of facilities considered the DC/TMD "useful" and 67% considered it "somewhat useful". The new classification was used to educate students and residents in 76% of facilities. Thus, the new classification is spreading widely as a result of its usefulness. Guidance in terms of treatment priority and a Japanese version of the DC/TMD including imaging criteria are required